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Sánchez-Romero LM, Li Y, Zavala-Arciniega L, Gallegos-Carrillo K, Thrasher JF, Meza R, Levy DT. The potential impact of removing a ban on electronic nicotine delivery systems using the Mexico smoking and vaping model (SAVM). MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.04.28.24306511. [PMID: 38746147 PMCID: PMC11092684 DOI: 10.1101/2024.04.28.24306511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
Objective To develop the Mexico Smoking and Vaping Model (Mexico SAVM) to estimate cigarette and electronic nicotine delivery systems (ENDS) prevalence and the public health impact of legalizing ENDS use. Methods SAVM, a cohort-based discrete-time simulation model, compares two scenarios. The ENDS-Restricted Scenario estimates smoking prevalence and associated mortality outcomes under the current policy of an ENDS ban, using Mexico-specific population projections, death rates, life expectancy, and smoking and e-cigarette prevalence. The ENDS-Unrestricted Scenario projects smoking and vaping prevalence under a hypothetical scenario where ENDS use is allowed. The impact of legalizing ENDS use is estimated as the difference in smoking- and vaping-attributable deaths (SVADs) and life-years lost (LYLs) between the ENDS-Restricted and Unrestricted scenarios. Results Compared to a national ENDS ban, The Mexico SAVM projects that legalizing ENDS use could decrease smoking prevalence by 40.1% in males and 30.9% in females by 2049 compared to continuing the national ENDS ban. This reduction in prevalence would save 2.9 (2.5 males and 0.4 females) million life-years and avert almost 106 (91.0 males and 15.5 females) thousand deaths between 2025 and 2049. Public health gains decline by 43% to 59,748 SVADs averted when the switching rate is reduced by half and by 24.3% (92,806 SVADs averted) with a 25% ENDS risk level from that of cigarettes but increased by 24.3% (121,375 SVADs averted) with the 5% ENDS risk. Conclusions Mexico SAVM suggests that greater access to ENDS and a more permissive ENDS regulation, simultaneous with strong cigarette policies, would reduce smoking prevalence and decrease smoking-related mortality. The unanticipated effects of an ENDS ban merit closer scrutiny, with further consideration of how specific ENDS restrictions may maximize public health benefits.
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Affiliation(s)
- Luz María Sánchez-Romero
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC. United States of America
| | - Yameng Li
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC. United States of America
| | - Luis Zavala-Arciniega
- Department of Epidemiology, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Katia Gallegos-Carrillo
- Epidemiology and Health Services Research Unit, Morelos, Mexican Institute of Social Security, Mexico
- Evaluation and Surveys Research Center, National Institute of Public Health, Cuernavaca, Mexico
| | - James F Thrasher
- Department of Health Promotion, Education & Behavior, Arnold School of Public Health, University of South Carolina, Columbia, United States of America
| | - Rafael Meza
- Department of Integrative Oncology, BC Cancer Research Institute, British Columbia, Canada
- School of Population and Public Health, University of British Columbia, Canada
| | - David T Levy
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC. United States of America
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2
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Hackworth EE, Budiongan JR, Lambert VC, Kim M, Ferguson SG, Niederdeppe J, Hardin J, Thrasher JF. A mixed-method study of perceptions of cigarette pack inserts among adult smokers from New York and South Carolina exposed as part of a randomized controlled trial. HEALTH EDUCATION RESEARCH 2023; 38:548-562. [PMID: 37450334 PMCID: PMC10714041 DOI: 10.1093/her/cyad030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 06/09/2023] [Accepted: 07/05/2023] [Indexed: 07/18/2023]
Abstract
While many countries require prominent pictorial health warning labels (PHWLs) on the outside of cigarette packs to communicate the harms of smoking, there is evidence that cigarette pack inserts that contain efficacy messages may enhance the effectiveness of PHWLs. The US Food and Drug Administration (FDA) has regulatory authority to communicate with smokers through inserts. While current labeling regulations do not require inclusion of inserts, the FDA could implement them in the future. This study assesses US smokers' perceptions of cigarette package inserts at the conclusion of a two-week randomized trial on cigarette labeling where half of participants were exposed to insert messages (two response-efficacy messages and two self-efficacy messages) in their packs. Participants (n = 359) completed a 30- to 60-min interview with both quantitative and qualitative assessments, including measures of recall and perceived message effectiveness (PME) for specific inserts. Correlates of recall and PME were estimated using mixed-effects regression models. Qualitative responses to PME items were analyzed using thematic analysis. Response-efficacy messages had higher PME and recall than self-efficacy messages. People had diverse responses to the inserts, including that they were positive, thought-provoking, and helpful. Reactions to and perceptions of the inserts indicate potential benefits of integrating efficacy messages into labeling policies.
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Affiliation(s)
- Emily E Hackworth
- Department of Health Promotion, Education, and Behavior, University of South Carolina, 915 Greene Street, Columbia, SC 29208, USA
| | - Julia R Budiongan
- Department of Health Promotion, Education, and Behavior, University of South Carolina, 915 Greene Street, Columbia, SC 29208, USA
| | - Victoria C Lambert
- Department of Health Promotion, Education, and Behavior, University of South Carolina, 915 Greene Street, Columbia, SC 29208, USA
| | - Minji Kim
- Department of Health Promotion, Education, and Behavior, University of South Carolina, 915 Greene Street, Columbia, SC 29208, USA
| | - Stuart G Ferguson
- Tasmanian School of Medicine, University of Tasmania, Hobart, Tasmania 7001, Australia
| | - Jeff Niederdeppe
- Department of Communication, Cornell University, 450 Mann Drive, Ithaca, NY 14853, USA
- Jeb E. Brooks School of Public Policy, Cornell University, Martha Van Rensselaer Hall, Ithaca, NY 14853, USA
| | - James Hardin
- Department of Epidemiology and Biostatistics, University of South Carolina, 915 Greene Street, Columbia, SC 29203, USA
| | - James F Thrasher
- Department of Health Promotion, Education, and Behavior, University of South Carolina, 915 Greene Street, Columbia, SC 29208, USA
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3
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Rodríguez-Bolaños R, Ramírez-Palacios P, Bolaños A, Lara D, Millan G, Gallegos-Carrillo K, Flores YN, Mejia RM, Cupertino AP, Cartujano-Barrera F. Decídetexto México: Recruitment and baseline characteristics of Mexican individuals who smoke in a cessation study. Tob Use Insights 2023; 16:1179173X231157378. [PMID: 37425216 PMCID: PMC10326465 DOI: 10.1177/1179173x231157378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/20/2023] Open
Abstract
The objective of this study was to evaluate the effectiveness of digital and traditional methods and strategies in the recruitment of Mexican individuals who smoke into a cessation study. Recruitment method refers in general to either digital or traditional recruitment. Recruitment strategies refer to the particular recruitment type utilized within each recruitment method. Traditional recruitment strategies included radio interviews, word of mouth, newspaper advertisement, posters/banners placed in primary healthcare clinics, and medical referrals. Digital recruitment strategies involved emails and study advertisements through social media (i.e., Facebook, Instagram and Twitter) and website. In a 4-month period, 100 Mexican individuals who smoke were successfully enrolled into a smoking cessation study. The majority of participants were enrolled via traditional recruitment strategies (86%) compared to the digital recruitment strategies (14%). Individuals screened in the digital method were more likely to be eligible to participate in the study, compared to the traditional method. Similarly, in comparison to the traditional method, individuals in the digital method were more likely to enroll in the study. However, these differences were not statistically significant. Both traditional and digital strategies made important contributions to the overall recruitment effort.
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Affiliation(s)
| | - Paula Ramírez-Palacios
- Unidad de Investigación
Epidemiológica y en Servicios de Salud Delegación Morelos, Instituto Mexicano del Seguro
Social, Cuernavaca, Mexico
| | - Alejandra Bolaños
- Departamento de Investigación Sobre
Tabaco, Instituto Nacional de Salud
Pública, Cuernavaca, Mexico
| | - Daimarelys Lara
- Department of Public Health
Sciences, University of Rochester Medical
Center, Rochester, NY, USA
| | - Gabriel Millan
- Departamento de Investigación Sobre
Tabaco, Instituto Nacional de Salud
Pública, Cuernavaca, Mexico
| | - Katia Gallegos-Carrillo
- Unidad de Investigación
Epidemiológica y en Servicios de Salud Delegación Morelos, Instituto Mexicano del Seguro
Social, Cuernavaca, Mexico
| | - Yvonne N Flores
- Unidad de Investigación
Epidemiológica y en Servicios de Salud Delegación Morelos, Instituto Mexicano del Seguro
Social, Cuernavaca, Mexico
| | - Raúl M Mejia
- Departamento de Medicina
Ambulatoria, Universidad de Buenos
Aires, Buenos Aires, Argentina
| | - Ana Paula Cupertino
- Department of Public Health
Sciences, University of Rochester Medical
Center, Rochester, NY, USA
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4
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Reed BW, Brody AL, Sanavi AY, Doran N. Associations between Tobacco Use, Surges, and Vaccination Status over Time in the COVID-19 Era. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1153. [PMID: 36673907 PMCID: PMC9859008 DOI: 10.3390/ijerph20021153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 01/06/2023] [Accepted: 01/06/2023] [Indexed: 06/17/2023]
Abstract
Because COVID-19 is a respiratory and cardiovascular disease, understanding behaviors that impact cardiopulmonary health, such as tobacco use, is particularly important. While early studies suggested no change in prevalence of tobacco use as COVID-19 emerged, pandemic fatigue, shifting levels of COVID-19 transmission, and vaccine availability have all changed since the start of the pandemic. The current study examined whether time, COVID-19 surges, and/or vaccination status were associated with likelihood of daily and non-daily tobacco use over the first 24 months of the pandemic. Data were obtained from electronic health records of healthcare visits (n = 314,787) to four Southern California VA healthcare systems. Multinomial logistic regression analyses indicated that the likelihood of reporting both daily and non-daily tobacco use (versus non-use) increased over time. Daily and non-daily tobacco use were less common at visits that occurred during COVID-19 surges, as well as among veterans vaccinated against COVID-19. Our findings provide new insight into changes of tobacco use patterns and correlates across the first two years of this pandemic, and understanding these associations may facilitate understanding of health-related behaviors and inform clinical treatment of tobacco use disorder during the COVID-19 pandemic.
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Affiliation(s)
- Brandon W. Reed
- Mental Health Care Line, VA San Diego Healthcare System, San Diego, CA 92161, USA
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, USA
| | - Arthur L. Brody
- Mental Health Care Line, VA San Diego Healthcare System, San Diego, CA 92161, USA
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, USA
| | - Andre Y. Sanavi
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, USA
| | - Neal Doran
- Mental Health Care Line, VA San Diego Healthcare System, San Diego, CA 92161, USA
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, USA
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5
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Anyanwu P, Moriarty Y, McCutchan G, Grozeva D, Goddard M, Whitelock V, Cannings-John R, Quinn-Scoggins H, Hughes J, Gjini A, Hepburn J, Osborne K, Robling M, Townson J, Waller J, Whitaker KL, Brown J, Brain K, Moore G. Health behaviour change among UK adults during the pandemic: findings from the COVID-19 cancer attitudes and behaviours study. BMC Public Health 2022; 22:1437. [PMID: 35902822 PMCID: PMC9332100 DOI: 10.1186/s12889-022-13870-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 07/12/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND COVID-19 related lockdowns may have affected engagement in health behaviours among the UK adult population. This prospective observational study assessed socio-demographic patterning in attempts to change and maintain a range of health behaviours and changes between two time points during the pandemic. METHODS Adults aged 18 years and over (n = 4,978) were recruited using Dynata (an online market research platform) and the HealthWise Wales platform, supplemented through social media advertising. Online surveys were conducted in August/September 2020 when lockdown restrictions eased in the UK following the first major UK lockdown (survey phase 1) and in February/March 2021 during a further national lockdown (survey phase 2). Measures derived from the Cancer Awareness Measure included self-reported attempts to reduce alcohol consumption, increase fruit/vegetable consumption, increase physical activity, lose weight and reduce/stop smoking. Multivariable logistic regressions were used to assess individual health behaviour change attempts over time, adjusted for age, sex, ethnicity, employment and education. RESULTS Around half of participants in survey phase 1 reported trying to increase physical activity (n = 2607, 52.4%), increase fruit/vegetables (n = 2445, 49.1%) and lose weight (n = 2413, 48.5%), with 19.0% (n = 948) trying to reduce alcohol consumption among people who drink. Among the 738 participants who smoked, 51.5% (n = 380) were trying to reduce and 27.4% (n = 202) to stop smoking completely. Most behaviour change attempts were more common among women, younger adults and minority ethnic group participants. Efforts to reduce smoking (aOR: 0.98, 95% CI: 0.82-1.17) and stop smoking (aOR: 0.98, 95% CI: 0.80-1.20) did not differ significantly in phase 2 compared to phase 1. Similarly, changes over time in attempts to improve other health behaviours were not statistically significant: physical activity (aOR: 1.07; 95% CI: 0.99-1.16); weight loss (aOR: 0.95; 95% CI: 0.90-1.00); fruit/vegetable intake (aOR: 0.98, 95% CI: 0.91-1.06) and alcohol use (aOR: 1.32, 95% CI: 0.92-1.91). CONCLUSION A substantial proportion of participants reported attempts to change health behaviours in the initial survey phase. However, the lack of change observed over time indicated that overall motivation to engage in healthy behaviours was sustained among the UK adult population, from a period shortly after the first lockdown toward the end of the second prolonged lockdown.
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Affiliation(s)
- Philip Anyanwu
- Centre for Medical Education, School of Medicine, Cardiff University, Cardiff, UK. .,Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, UK.
| | | | - Grace McCutchan
- Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, UK
| | | | - Mark Goddard
- Centre for Trials Research, Cardiff University, Cardiff, UK
| | | | | | - Harriet Quinn-Scoggins
- PRIME Centre Wales, Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, UK
| | | | - Ardiana Gjini
- Public Health Wales, Cardiff, UK.,Cardiff University, Cardiff, UK
| | - Julie Hepburn
- Public Involvement Community, Health and Care Research Wales Support Centre, Cardiff, UK
| | | | - Michael Robling
- Centre for Trials Research, Cardiff University, Cardiff, UK.,DECIPHer (Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement), School of Social Sciences, Cardiff University, Cardiff, UK
| | - Julia Townson
- Centre for Trials Research, Cardiff University, Cardiff, UK
| | - Jo Waller
- School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
| | | | - Jamie Brown
- Department of Behavioural Science and Health, University College London, London, UK
| | - Kate Brain
- PRIME Centre Wales, Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, UK
| | - Graham Moore
- DECIPHer (Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement), School of Social Sciences, Cardiff University, Cardiff, UK
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6
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Hernández-Díaz Y, Genis-Mendoza AD, Ramos-Méndez MÁ, Juárez-Rojop IE, Tovilla-Zárate CA, González-Castro TB, López-Narváez ML, Nicolini H. Mental Health Impact of the COVID-19 Pandemic on Mexican Population: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116953. [PMID: 35682536 PMCID: PMC9180045 DOI: 10.3390/ijerph19116953] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 05/31/2022] [Accepted: 06/01/2022] [Indexed: 12/23/2022]
Abstract
The COVID-19 pandemic has had an impact on mental health in the general population, but no systematic synthesis of evidence of this effect has been undertaken for the Mexican population. Relevant studies were identified through the systematic search in five databases until December, 2021. The selection of studies and the evaluation of their methodological quality were performed in pairs. The Newcastle-Ottawa Scale (NOS) was used for study quality appraisal. The protocol of this systematic review was registered with PROSPERO (protocol ID: CRD42021278868). This review included 15 studies, which ranged from 252 to 9361 participants, with a total of 26,799 participants. The findings show that COVID-19 has an impact on the Mexican population’s mental health and is particularly associated with anxiety, depression, stress and distress. Females and younger age are risk factors for development mental health symptoms. Mitigating the negative effects of COVID-19 on mental health should be a public health priority in Mexico.
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Affiliation(s)
- Yazmín Hernández-Díaz
- División Académica Multidisciplinaria de Jalpa de Méndez, Universidad Juárez Autónoma de Tabasco, Jalpa de Mendez 86205, Mexico; (Y.H.-D.); (T.B.G.-C.)
| | - Alma Delia Genis-Mendoza
- Laboratorio de Genómica de Enfermedades Psiquiátricas y Neurodegenerativas, Instituto Nacional de Medicina Genómica, Mexico City 14610, Mexico;
| | - Miguel Ángel Ramos-Méndez
- División Académica de Ciencias de la Salud, Universidad Juárez Autónoma de Tabasco, Beautiful Villa 86100, Mexico;
| | - Isela Esther Juárez-Rojop
- División Académica Multidisciplinaria de Comalcalco, Universidad Juárez Autónoma de Tabasco, Comalcalco 86040, Mexico;
| | - Carlos Alfonso Tovilla-Zárate
- Hospital Chiapas “Dr. Jesús Gilberto Gómez Maza”, Tuxtla Gutierrez 29000, Mexico;
- Correspondence: (C.A.T.-Z.); (H.N.)
| | - Thelma Beatriz González-Castro
- División Académica Multidisciplinaria de Jalpa de Méndez, Universidad Juárez Autónoma de Tabasco, Jalpa de Mendez 86205, Mexico; (Y.H.-D.); (T.B.G.-C.)
| | | | - Humberto Nicolini
- Laboratorio de Genómica de Enfermedades Psiquiátricas y Neurodegenerativas, Instituto Nacional de Medicina Genómica, Mexico City 14610, Mexico;
- Correspondence: (C.A.T.-Z.); (H.N.)
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Wang X, Ma Z, Wang C. A Longitudinal Study on the Addictive Behaviors of General Population before and during the COVID-19 Pandemic in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19105979. [PMID: 35627516 PMCID: PMC9141667 DOI: 10.3390/ijerph19105979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 04/27/2022] [Accepted: 05/12/2022] [Indexed: 01/27/2023]
Abstract
By using nationally representative longitudinal data, this study investigates the effects of the COVID-19 pandemic on the addictive behaviors (smoking and drinking) of the general population in China. From the China Family Panel Studies (CFPS) 2018 and 2020, we extract a sample of individuals over 16 years of age in China, consisting of 14,468 individuals and 28,936 observations. We decompose the sample into three age groups, that is, ages between 16 and 39, ages between 40 and 59 and ages above 60. The bootstrap method is used to estimate the confidence interval of the difference in the mean of addictive behaviors, and logit models are used in the regression analysis. Our results show that the COVID-19 pandemic reduces the smoking behavior of individuals above 40 years of age, and that it reduces the drinking behavior of individuals above 16 years of age. However, the pandemic increases the smoking behavior of individuals between 16 and 39 years of age. These results may be closely related to the characteristics of COVID-19 (that is, a respiratory system disease), the working and economic pressures of young Chinese and the role of drinking alcohol in building and maintaining social networks in China.
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Affiliation(s)
- Xiaoyu Wang
- Institute of Population and Labor Economics, Chinese Academy of Social Sciences, Beijing 100006, China;
| | - Zaifei Ma
- School of Statistics, Renmin University of China, Beijing 100872, China;
| | - Chunan Wang
- School of Economics and Management, Beihang University, Beijing 100191, China
- Beihang Hangzhou Innovation Institute Yuhang, Hangzhou 310023, China
- MoE Key Laboratory of Complex System Analysis and Management Decision, Beijing 100191, China
- Correspondence:
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